[1]仪 凡,王晓旭,林诗佳,等.刺络放血治疗寻常型银屑病疗效及安全性Meta分析[J].陕西中医杂志,2023,(6):794-800.[doi:DOI:10.3969/j.issn.1000-7369.2023.06.026]
　YI Fan,WANG Xiaoxu,LIN Shijia,et al.Systematic evaluation of the efficacy and safety of blood-letting puncture in the treatment of psoriasis vulgaris[J].,2023,(6):794-800.[doi:DOI:10.3969/j.issn.1000-7369.2023.06.026]
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刺络放血治疗寻常型银屑病疗效及安全性Meta分析
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《陕西中医》杂志[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2023年6期
页码:
794-800
栏目:
Meta分析
出版日期:
2023-06-05

文章信息/Info

Title:
Systematic evaluation of the efficacy and safety of blood-letting puncture in the treatment of psoriasis vulgaris
作者:
仪 凡1; 2; 王晓旭2; 林诗佳1; 丁 薇1; 张广中2
(1.北京中医药大学,北京 100020; 2.首都医科大学附属北京中医医院,北京 100010)
Author(s):
YI Fan; WANG Xiaoxu; LIN Shijia; DING Wei; ZHANG Guangzhong
(Beijing University of Chinese Medicine,Beijing 100020,China)
关键词:
寻常型银屑病;  刺络放血;  安全性;  随机对照试验;  系统评价;  Meta分析
Keywords:
Blood-letting puncture;  Psoriasis vulgaris;  Safety;  Randomized controlled trial;  Systematic evaluation;  Meta analysis
分类号:
R 758.63
DOI:
DOI:10.3969/j.issn.1000-7369.2023.06.026
文献标志码:
A
摘要:
目的:系统评价刺络放血治疗寻常型银屑病的效果与安全性。方法:检索建库以来应用刺络放血疗法治疗寻常型银屑病的随机对照试验(RCT),由2名研究者分别独立进行文献筛选和资料提取、并评价偏倚风险后,利用Rev Man 5.4软件合并分析。主要评价指标为:总有效率、银屑病面积与严重性指数(PASI评分)、红斑、鳞屑、浸润、瘙痒等皮损症状、银屑病患者生活质量(PQOLS评分)、复发率、不良反应发生率等。结果:共纳入12个RCT,共计997例患者。本系统评价结果显示联用刺络放血疗法较其他治疗方式在提高临床有效率[RR=1.15,95%CI(1.09,1.21),P<0.00001]、降低PASI评分[MD=-0.96,95%CI(-1.09,-0.82),P<0.00001]、改善红斑、鳞屑症状[红斑:MD=-0.65,95%CI(-1.15,-0.15),P=0.01; 鳞屑:MD=-0.47,95%CI(-0.74,-0.20),P=0.0007]、减少不良反应[RR=0.49,95%CI(0.24,0.98),P=0.04]、减少复发[RR=0.41,95%CI(0.22,0.76),P=0.005]、提高生活质量[MD=-1.78,95%CI(-2.48,-1.08),P<0.00001]方面差异显著,具有统计学意义。但在浸润[MD=-0.33,95%CI(-0.91,0.25),P=0.26]和瘙痒症状[MD=-0.79,95%CI(-1.64,0.06),P=0.07]两方面并无统计学意义。结论:刺络放血疗法治疗寻常型银屑病有效率高、安全性好、复发率小。但本研究纳入文献数据质量偏低,样本量不足,今后亟需开展大样本、高质量研究对刺络放血疗法的疗效优势进一步科学验证。
Abstract:
Objective:To systematically evaluate the efficacy and safety of pricking collaterals and bloodletting in the treatment of psoriasis vulgaris. Methods:Randomized controlled trials(RCTs)of pricking blood therapy in the treatment of psoriasis vulgaris since the establishment of the database were retrieved.Two researchers independently conducted literature screening and data extraction,and evaluated the risk of bias.Rev Man 5.4 software was used for combined analysis.The main evaluation indexes were:the total effective rate,psoriasis area and severity index(PASI score),erythema,scales,infiltration,itching and other skin lesions,quality of life in patients with psoriasis(PQOLS score),recurrence rate,incidence of adverse reactions,etc. Results:A total of 12 RCTs with a total of 997 patients were included.The results of this systematic review show that the combined use of pricking and bloodletting therapy compared with other treatments can improve the clinical effective rate [RR=1.15,95%CI(1.09,1.21), P<0.00001] and reduce the PASI score [MD=-0.96,95%CI(-1.09,-0.82),P<0.00001],improved erythema,scaling symptoms [erythema:MD=-0.65,95%CI(-1.15,-0.15), P=0.01; scaling:MD=-0.47,95% CI(-0.74,-0.20),P=0.0007],reduction in adverse effects [RR=0.49,95%CI(0.24,0.98), P=0.04],reduction in recurrence [RR=0.41,95%CI(0.22,0.76),P=0.005],and improved quality of life [MD=-1.78,95%CI(-2.48,-1.08),P<0.00001],the difference was significant and statistically significant.However,there were no statistics for infiltration [MD=-0.33,95%CI(-0.91,0.25),P=0.26] and pruritus symptoms [MD=-0.79,95%CI(-1.64,0.06),P=0.07] study meaning.Conclusion:Bloodletting therapy for pricking collaterals has high efficacy,good safety and low recurrence rate in the treatment of psoriasis vulgaris.However,the quality of the literature data included in this study is low.In the future,it is urgent to carry out large-sample and high-quality research to further scientifically verify the therapeutic advantages of bloodletting therapy.

参考文献/References:

[1] 中华医学会皮肤性病学分会银屑病专业委员会.中国银屑病诊疗指南(2018完整版)[J].中华皮肤科杂志,2019,52(10):667-710.
[2] 晋红中,吴 超.银屑病的共病:研究现状与前景[J].实用皮肤病学杂志,2020,13(4):193-197.
[3] 苗春澍,李 娜,李翔宇,等.开玄消银汤联合中药药浴治疗寻常型银屑病临床研究[J].陕西中医,2022,43(11):1535-1539.
[4] 龚 坚,刘 巧.中西医结合治疗银屑病思路与方法[J].中华中医药杂志,2021,36(7):4100-4103.
[5] 程亚清,李 雪,曲海顺,等.祛风除湿法治疗IgA肾病的Meta分析[J].世界中医药,2020,15(19):2888-2899.
[6] 仪 凡,王晓旭,赵子慧,等.从肝论治寻常型银屑病伴焦虑抑郁Meta分析[J].陕西中医,2022,43(11):1632-1637.
[7] 王 红,秦兰英.NB-UVB联合刺络拔罐治疗中重度寻常型银屑病的疗效观察[J].智慧健康,2021,7(5):37-39.
[8] 张丽艳,符润娥,王 琪.研究刺血拔罐配合他克莫司治疗斑块型银屑病的疗效[J].健康大视野,2021,17(1):253.
[9] 凌晓燕,高丛珊,张春燕.背俞穴拔罐放血疗法联合凉血消银丸治疗寻常型银屑病(血热证)的临床观察[J].中国民间疗法,2020,28(5):40-42.
[10] 宗世琴,付勇刚,希 茜,等.刺络拔罐联合中药内服治疗血瘀型寻常型银屑病的效果观察[J].中医药临床杂志,2020,32(8):1576-1579.
[11] 李 娜.甘露消毒丹联合刺络放血治疗寻常型银屑病的临床观察[D].昆明:云南中医药大学,2019.
[12] 阳知丽.梅花针叩刺放血联合活血散瘀汤治疗血瘀证斑块型银屑病临床观察[D].长沙:湖南中医药大学,2017.
[13] 徐 蓉,陈炳兆,茅玮炜,等.中药联合刺络拔罐法治疗寻常性银屑病“血热证”的临床研究[J].中华中医药学刊,2018,36(10):2428-2431.
[14] 何 花,董大立,蒋谷芬.刺络拔罐治疗血热证银屑病患者的护理观察[J].护士进修杂志,2017,32(1):70-71.
[15] 季艳芳.刺络放血法治疗斑块状银屑病的临床分析[J].中医临床研究,2015,7(22):116-117.
[16] 张秋婷,黄茹茜,王 婷.刺血拔罐联合NB-UVB治疗斑块型银屑病疗效观察及护理[J].湖北中医杂志,2015,37(3):64-65.
[17] 刘忠亮.刺络放血法联合中药治疗银屑病血瘀热结证临床疗效观察[D].济南:山东中医药大学,2012.
[18] 李景利,宋 坪,赵 婷.刺络放血法联合常规中药治疗斑块状银屑病临床观察[J].北京中医药,2010,29(12):895-897.
[19] 呼肖娜,李卫红.依那西普对银屑病大鼠模型固有淋巴细胞亚群分型的影响[J].陕西医学杂志,2022,51(8):921-924.
[20] 严松华,禚欣欣,顾丽娟,等.阿维A联合卡泊三醇软膏治疗斑块状银屑病的疗效及安全性分析[J].陕西医学杂志,2016,45(12):1673-1674.
[21] 张媛凤,张 冰,周伟龙.张冰运用“一毒三法”辨治寻常型银屑病经验撷萃[J].中华中医药杂志,2019,34(1):173-176.
[22] 于 萍,石慧婧,袁 伟,等.阿达木单抗引起银屑病不良反应一例[J].中华风湿病学杂志,2021,25(10):686-687.
[23] 赵雨晴,魏志平,周 迪,等.舒肝健脾养血法对寻常型银屑病患者免疫功能、炎症因子的影响[J].陕西中医,2022,43(1):69-72.
[24] 吴 昊,李忻红.放血疗法治疗寻常型银屑病的临床研究概述及风险讨论[J].江西中医药,2019,50(4):76-78.
[25] 胡 妍.热敏灸配合刺络放血治疗椎动脉型颈椎病临床观察[J].中国中医药现代远程教育,2019,17(22):103-105.
[26] 贺成功,龙红慧,徐天馥,等.放血疗法的临床实践[J].长春中医药大学学报,2017,33(1):85-88.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金资助项目(82274523)
更新日期/Last Update: 2023-06-09